Study finds COPD patients developed depression during early stages of epidemic

Screening all patients with chronic obstructive pulmonary disease (COPD), whether they have a history of depression or not, to potentially mitigate the mental health impacts of the COVID-19 pandemic, according to a study published in And intervention is required. International Journal of Chronic Obstructive Pulmonary Disease,

Research has found that older adults with COPD have a higher risk of depression than people without COPD. A recent study showed that exercise helps improve physical and depressive symptoms in patients with COPD, emphasizing “the importance of exercise-based interventions to support the mental well-being of individuals with COPD”. Is.

Researchers reported that the COVID-19 pandemic lockdown prevented people from getting enough exercise daily. They hypothesized that lack of physical activity contributed to poorer physical and mental health among older adults with COPD, as they are more likely to experience severe symptoms and mortality from COVID-19.

To address the unknown mental impacts of COVID-19, researchers conducted a study to identify the prevalence of depression and its associated factors for the first time during the pandemic in those without a history of depression. They also analyzed the prevalence and factors associated with recurrence and/or persistence of depression during the pandemic in COPD patients with a history of depression.

The study population was created using the Canadian Longitudinal Study on Aging (CLSA), “a large national study that recruited Canadian older adults aged 45 to 85 years.” The researchers noted that their analysis was limited to CLSA respondents with COPD during the baseline (conducted between 2011-2015) or follow-up 1 (conducted 2015-2018) waves; The population consisted of 875 respondents. Data from the COVID-19 spring 2020 wave (conducted April 15–May 30, 2020) and COVID-19 autumn 2020 wave (conducted September 29–December 29, 2020) were also analyzed for relevant respondents.

Researchers diagnosed COPD in respondents through answers to the question, “Has a doctor told you that you have/had any of the following: emphysema, chronic bronchitis, COPD, or long-term changes in the lungs caused by smoking?” ” Those who answered 1 were given a COPD diagnosis, while those who answered 0 were not.

Additionally, they measured first-onset depression during the pandemic with the Center for Epidemiological Studies Short Scale of Depression (CES-D-10) as part of the autumn 2020 questionnaire. The CES-D-10 uses 10 items to measure depressive symptoms experienced over the past 7 days, with a total score ranging from 0 to 30. People with a score of 10 or higher receive a depression diagnosis, with higher scores indicating higher severity.

Researchers identified lifetime depression through 4 measurements, CES-D-10 scores from baseline and follow-up 1 waves where participants were asked, “Has your doctor ever told you that you have clinical depression? ” People whose score was less than 10 and who answered “no” to the question in both steps were classified as not suffering from pre-pandemic depression. However, if at least 1 of the 4 results indicated depression at baseline or follow-up 1, researchers classified the respondent as having pre-pandemic depression.

Depressed woman Image Credit: Kittyfan –


The study findings showed that nearly 1 in 6 (17%) respondents with COPD developed depression during the early stages of the epidemic and had no lifetime history of depression. Additionally, nearly 1 in 2 (52%) respondents with a history of COPD and depression experienced a recurrence of depressive symptoms during the study period.

They were associated with functional limitations (odds ratio). [OR], 3.38; 95% CI, 1.70–6.72; P <.001), difficulties accessing health care (OR, 2.14; 95% CI, 1.17-3.89; P = .013), and increased family conflict during the pandemic (OR, 2.68; 95% CI, 1.17–6.14; P , .019) with higher risk of incident depression. On the other hand, researchers noted that women had a higher risk of recurrent depressive symptoms than men (OR, 1.88; 95% CI, 1.06-3.34; P , .033), and respondents who felt frequently lonely during the first few months of the pandemic were more likely to have frequent depressive symptoms (OR, 3.26; 95% CI 1.83–5.83; P <.001).

The researchers also found that those who had a post-secondary degree (OR, 3.00; 95% CI, 1.12-8.05; P , .029) and older respondents with higher adverse childhood experiences (OR, 1.44; 95% CI, 1.03–2.02; P , .033) were more likely to be depressed during the pandemic.

They acknowledged that their study had limitations, one being that the analysis relied on self-reported COPD, which cannot be considered a definitive medical diagnosis. Furthermore, self-reported COPD data were only taken during the follow-up 1 questionnaire, meaning that any patients who later developed COPD would have been misclassified.

The researchers noted that these limitations did not diminish their findings, as it helped them “better understand the effects of the COVID-19 pandemic on the mental health of this population.”

The authors concluded, “The findings indicate an increased risk of both incident and recurrent depression in older adults with COPD during the pandemic.” “Health care professionals should be aware of the mental health impacts of COVID-19 on individuals with COPD and continue to screen their COPD patients for depression to support their mental well-being.”

Tonke A, Li G, McNeil A, et al. Breathlessness and blues in the Canadian Longitudinal Study on Aging: Incidence and recurrent depression in older adults with COPD during the course of COPD. Int J Chron Obstruct Pulmon Dis, 2023;18:1975-1993. doi:10.2147/copd.s417218

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